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In Context
- Recently, the India Family Planning 2030 Vision document was unveiled at National Family Planning Summit 2022.
Summit highlights
- During the event following things were initiated/introduced by the Minister of State for Health and Family Welfare:
- The India Family Planning 2030 vision document and
- Launching of the Medical Eligibility Criteria (MEC) Wheel Application,
- E-Module of Family Planning Logistics Management System (FPLMIS), and
- Digital Archive on Family Planning under the category of Digital Intervention.
- Introduction of:
- National Family Planning helpline manual,
- Community Health Officer (CHO) booklet, and
- ASHA brochure and leaflet (Family Planning).
The India Family Planning 2030 vision document highlights
- Population estimates:
- India is the second largest country in the world.
- The country’s population is expected to continue to grow until mid-century (due to population momentum), however, the population growth will decline substantially, said the document.
- Priority areas are identified in the Centre’s family planning vision document 2030:
- Strategies to overcome teenage childbearing,
- Lack of male participation in awareness programmes,
- Migration and lack of access to contraceptives.
- It also includes a plan to use the private sector for providing modern contraceptives.
Outcomes of India’s Family planning efforts
- Achieving replacement level fertility:
- India has achieved replacement level fertility, with as many as 31 States/Union Territories reaching a Total Fertility Rate of 2.1 or less.
- Increased usage of modern contraceptives:
- Between 2012 and 2020, India added more than 1.5 crores, additional users, for modern contraceptives thereby increasing their use substantially.
- Positive birth spacing methods:
- Government data shows an overall positive shift towards spacing methods which would be instrumental in impacting positively maternal and infant mortality and morbidity.
Issues & Challenges
- Low contraceptive use:
- While multiple factors have been identified that explain low contraceptive use among married adolescents and young women, two most important factors are child marriage and teenage pregnancy.
- Concerning teenage childbearing:
- High teenage fertility in some areas remains a cause of concern in India even as the fertility rate has stabilised across the country.
- The decline in teenage childbearing was minimal – 7.9% in 2015-16 to 6.8% in 2019-21.
- High teenage fertility in some areas remains a cause of concern in India even as the fertility rate has stabilised across the country.
- State-specific data:
- Teenage pregnancies:
- Over 118 districts reported high percentage of teenage pregnancies and are mostly concentrated in Bihar, West Bengal, Assam, Maharashtra, Jharkhand, Andhra Pradesh and Tripura.
- Child marriage:
- Additionally, over 44% of the districts in India reported high percentage of women marrying before they reach the age of 18.
- These districts were in the States of Bihar, West Bengal, Jharkhand, Assam, Uttar Pradesh, Rajasthan and Maharashtra.
- Coincidentally, these districts also experience low rates of modern contraceptive use.
- Teenage pregnancies:
India’s efforts toward family planning & Population Control
- National Programme for Family Planning:
- Initial Phase:
- India was the first country in the world to have launched a National Programme for Family Planning in 1952.
- India’s Total Fertility Rate was 6 when it commenced its population control programme.
- Over the decades, the programme has undergone a transformation in terms of policy and actual programme implementation
- Development of programme:
- It is currently being repositioned to not only achieve population stabilization goals but also promote reproductive health and reduce maternal, infant & child mortality and morbidity.
- Under the programme public health sector provides various family planning services at various levels of the health system.
- Comparing India’s family planning with China’s:
- Comparisons with China would be misplaced because force was the leitmotif of Beijing’s three-and-a-half-decade-long one-child policy.
- Governments in India — except for a brief lapse into forced sterilisation during the Emergency — have, in contrast, deployed persuasion and education as tools.
- Initial Phase:
- Mission Pariwar Vikas:
- For improved access to contraceptives and family planning services in high fertility districts spreading over seven high-focus states, the Ministry of Health and Family Welfare launched “Mission Pariwar Vikas”in 2016.
- Mission Parivar Vikas (MPV) has given further impetus to the National Family Planning Program.
- A special focus has been given to 146 high fertility Districts of Bihar, Uttar Pradesh, Assam, Chhattisgarh, Madhya Pradesh, Rajasthan & Jharkhand,
- Goal:
- Its overall goal is to reduce India’s overall fertility rate to 2.1 by the year 2025
- Under Mission Parivar Vikas (MPV), innovative strategies like the distribution of Nayi Pehel kits, Saas Bahu Sammelan, and Saarthi vans are helping in reaching out to the community and initiating dialogues on Family Planning and healthy birth spacing, and the importance of small families.
- For improved access to contraceptives and family planning services in high fertility districts spreading over seven high-focus states, the Ministry of Health and Family Welfare launched “Mission Pariwar Vikas”in 2016.
- HumDo:
- The National Family Planning Programme, through Hum Do aims to provide eligible couples with information and guidance on family planning methods and services available and to ensure individuals and couples lead a healthy, happy and prosperous life.
Way ahead
- Role of frontline workers:
- The training of frontline workers like ASHAs and auxiliary nurse midwife (ANM) has to be technical and beyond.
- There needs to be greater emphasis on trainings around community mobilization and counselling for contraceptive technologies, addressing myths and misconceptions prevailing in the communities regarding modern methods of contraception.
- The social stigma surrounding abortion compels women to resort to unsafe abortion methods at the hands of unqualified service providers.
- The training of frontline workers like ASHAs and auxiliary nurse midwife (ANM) has to be technical and beyond.
- Service delivery:
- To ensure that quality services reach the last mile, services need to be geographically convenient.
- Quality services cannot be provided in the absence of adequate infrastructure and competent and unbiased service providers and frontline workers.
- Shared responsibility of men and women:
- In many parts of the world including India, family planning is largely viewed as a women’s issue.
- There needs to be greater recognition of the fact that decision-making on contraceptive use is the shared responsibility of men and women
- Collective engagement:
- The success of India’s family planning programme is shouldered by researchers, policymakers, service providers and users, who will need to do their part to ensure equitable access to quality family planning services.
Source: TH
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